摘要
目的:探讨参附注射液对急性冠脉综合征并心源性休克的治疗效果。方法:选择急性冠脉综合征并发心源性休克患者72例,随机分为对照组和治疗组各36例,两组均给予抗心肌梗死和抗休克常规治疗,治疗组加用参附注射液静滴治疗。比较两组治疗后的临床疗效、中医证候积分和治疗前、治疗后3 d,7 d的左心室射血分数(LVEF)、心脏指数(CI)、每搏输出量(SV)、中心静脉压(CVP)、全心舒张末容积指数(GEDI)、平均动脉压(MAP)、心率(HR)和肌钙蛋白I(cTnI)、肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、脑钠肽(BNP)及住院期间病死率和IABP率。结果:治疗组总有效率高于对照组(P<0.05),在治疗后3 d,7 d两组TCM积分、cTnI、CK-MB、MYO、BNP均较治疗前降低(P<0.05),且各时间点治疗组均低于对照组(P<0.05);治疗后3 d和7 d,两组CI、LVEF、SV、CVP、MAP均较治疗前升高,HR均较治疗前降低(P<0.05);治疗后7 d治疗组CI、LVEF、SV、MAP均高于对照组,HR低于对照组(P<0.05)。两组病死率和IABP率差异无统计学意义(P>0.05)。结论:参附注射液治疗急性冠脉综合征并心源性休克可以改善血流动力学状态和心肌损伤标志物,其治疗效果随治疗时间延长而增加。
Objective:To explore the effects of Shenfu injection in the treatment of acute coronary syndrome with cardiogenic shock.Methods:72 patients with acute coronary syndrome complicated with cardiogenic shock were randomly divided into the control group(n=36)and the treatment group(n=36).The two groups were given anti-myocardium and anti-shock according to the guidelines.The treatment group was given Shenfu injection intravenous additionally.The clinical efficacy after treatment and the TCM syndrome scores,left ventricular ejection fraction(LVEF),heart index(CI),stroke utput(SV),central venous pressure(CVP),global end-diastolic volume index(GEDI),mean arterial pressure(MAP),heart rate(HR),serum myocardial injury markers[troponin I(cTnI),muscle Acid kinase isoenzyme(CKMB),myoglobin(MYO),brain natriuretic peptide(BNP)],mortality during hospitalization and intra-aortic balloon counterpulsation(IABP)before treatment,3 days after treatment and 7 days after treatment were compared.Results:The total effective rate of the treatment group was higher than that of the control group(P<0.05).At 3 and 7 days after treatment,the TCM syndrome scores,cTnI,CK-MB,MYO and BNP of the two groups were lower than those before treatment(P<0.05),and the treatment group was lower than that of the control group at each time point(P<0.05).At 3 and 7 days after treatment,the CI,LVEF,SV,CVP and MAP of the two groups were higher than those before treatment,and HR was lower than that before treatment(P<0.05).At 7 day,CI,LVEF,SV and MAP were higher in the treatment group than in the control group,and the HR was lower than that of the control group(P<0.05).There was no significant difference in mortality and IABP between the two groups(P>0.05).Conclusion:Shenfu injection can improve hemodynamic status and myocardial injury markers in patients with acute coronary syndrome and cardiogenic shock.The therapeutic benefit increases with the treatment time.
作者
林冰
蒋丽芳
郭应军
LIN Bing;JIANG Lifang;GE Yingjun(The Traditional Chinese Medicine Hospital of Zhongshang City,Zhongshang 528400,China)
出处
《华夏医学》
CAS
2020年第1期51-56,共6页
Acta Medicinae Sinica
